Tic Disorder

Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person with a motor tic might keep blinking over and over again, or a person with a vocal tic might make a grunting sound unwillingly. 

Tics are thought to be due to changes in the parts of the brain that control movement. They can run in families, and there’s likely to be a genetic cause in many cases. They also often happen alongside other conditions such as Attention Deficit Hyperactivity Disorder (ADHD). 

Tics are irregular, uncontrollable, unwanted, and repetitive movements of muscles that can occur in any part of the body. Movements of the limbs and other body parts are known as motor tics. Involuntary repetitive sounds, such as grunting, sniffing, or throat clearing, are called vocal tics. 

Tic disorders usually start in childhood, first presenting at approximately 5 years of age. In general, they are more common among males compared with females. Many cases of tics are temporary and resolve within a year. However, some people who experience tics develop a chronic disorder. 

Transient Tic Disorder 

According to the American Academy of Child and Adolescent Psychiatry, Transient Tic Disorder or Provisional Tic Disorder affects up to 10 percent of children during their early school years. 

Children with Transient Tic Disorder will present with one or more tics for at least one month, but for less than 12 consecutive months. The onset of the tics must have been before the individual turned 18 years of age. Motor tics are more commonly seen in cases of transient tic disorder than vocal tics. Tics may vary in type and severity over time. 

Some research suggests that tics are more common among children with learning disabilities and are seen more in special education classrooms. Children within the Autism Spectrum are also more likely to have tics. 

Tics that appear before the age of 18 and last for one year or more may be classified as a chronic tic disorder. These tics can be either motor or vocal, but not both. Chronic tic disorder is less common than transient tic disorder, with less than one percent of children affected. If the child is younger at the onset of a chronic motor or vocal tic disorder, they have a greater chance of recovery, with tics usually disappearing within six years. People who continue to experience symptoms beyond age 18 are less likely to see their symptoms resolved. 

The defining symptom of tic disorders is the presence of one or more tics. These tics can be classified either motor tics such as head and shoulder movements, blinking, jerking, banging, clicking fingers, or touching things or other people. Motor tics tend to appear before vocal tics, although this is not always the case. Or vocal tics such as coughing, throat clearing or grunting, or repeating words or phrases. 

Tics can also be divided into two categories: 

• Simple tics which are sudden and fleeting tics using few muscle groups. Examples include nose twitching, eye darting, or throat clearing
• Complex tics involving coordinated movements using several muscle groups. Examples include hopping or stepping in a certain way, gesturing, or repeating words or phrases

Tics are usually preceded by an uncomfortable urge, such as an itch or tingle. While it is possible to hold back from carrying out the tic, this requires a great deal of effort and often causes tension and stress. Relief from these sensations is experienced upon carrying out the tic. 

• When the child has one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase)
• Motor or vocal tics have been present for no longer than 12 months in a row and have tics that start before age 18 years
• When the child has symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics (for example, Huntington Disease or Postviral Encephalitis) and lastly not have been diagnosed with TS or persistent motor or vocal tic disorder